| 曹杰,吕辉照,赵枫,等.螺纹外露对外固定架钉道感染的影响.骨科,2019,10(2): 120-124. |
| 螺纹外露对外固定架钉道感染的影响 |
| Relationship between extracutaneous screw thread and external fixator pin tract infection |
| 投稿时间：2018-08-16 |
| DOI：10.3969/j.issn.1674-8573.2019.02.008 |
| 中文关键词: 外固定架 钉道感染 螺纹外露 |
| 英文关键词: External fixator Pin tract infection Screw thread, extracutaneous |
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| 中文摘要: |
| 目的 观察螺纹外露对外固定钉道感染的影响。方法 回顾性分析2003年12月至2017年1月我院骨科收治的332例胫腓骨开放性骨折病人的临床资料，均采用单边外固定架临时固定。其中男220例，女112例；左侧177例，右侧155例；年龄为（33.4±2.6）岁（27~51岁）。按Gustilo分型：Ⅱ型79例，Ⅲ型253例。外固定架固定时间为（76.3±9.2） d（66~93 d）。按螺纹是否外露，分为皮外组与皮内组，其中皮外组164例，皮内组168例。取出Schanz螺钉时，采集钉道浅表和深部的分泌物样本，并送细菌培养。记录钉道愈合情况、浅表和深部细菌培养结果及其类型。结果 皮内组钉道愈合等级（甲级：66例；乙级：99例；丙级：3例）优于皮外组（甲级：50例；乙级：90例；丙级：24例），差异有统计学意义（χ2=19.456，P=0.001）。皮外组浅表感染96例，皮内组浅表感染101例，差异无统计学意义（χ2=0.086，P=0.769）。皮外组深部感染21例，皮内组2例，两组比较差异有统计学意义（χ2=17.362，P=0.001）。皮外组与皮内组钉道感染均以金黄色葡萄球菌为主要菌种，两组间的细菌构成比比较，差异无统计学意义（Z=-0.135，P＞0.05）。结论 螺纹外露会增加单边外固定深部感染概率，应尽量将螺纹置入皮下或选择短螺纹螺钉。 |
| 英文摘要: |
| Objective To investigate the relationship between extracutaneous screw thread and external fixator pin tract infection. Methods From December 2003 to January 2017, 332 patients with tibiofibular fractures were treated with unilateral external fixators. The clinical data of the patients were retrospectively analyzed. There were 220 males and 112 females with age of (33.4±2.6) years old (27-51 years). There were 177 cases on left side, and 155 cases on right side. According to the Gustilo standard, there were 79 cases for type Ⅱ, and 253 cases for type Ⅲ. The fixation duration time was (76.3±9.2) days (66-93 days). All patients were divided into extracutaneous group (164 cases) and intracutaneous group (168 cases) according to whether the threads were exposed. When the Schanz screw was removed, the superficial and deep secretion samples were collected for bacterial culture. The healing of nail canal, superficial and deep bacterial culture results and types were recorded. Results The healing grade of nail canal in intradermal group (class A: 66 cases; class B: 99 cases; class C: 3 cases) was better than that in extracutaneous group (class A: 50 cases; class B: 90 cases; class C: 24 cases) (χ2=19.456, P=0.001). There was no significant difference in superficial infection between extracutaneous group (96 cases) and intradermal group (101 cases) (χ2=0.086, P=0.769). There were 21 cases of deep infection in extracutaneous group and 2 cases in intracutaneous group with significant difference (χ2=17.362, P=0.001). Staphylococcus aureus was the main strain of nail tract infection in both groups, and there was no significant difference in bacterial composition between the two groups (Z=-0.135, P＞0.05). Conclusion Extracutaneous external fixator screw thread can increase the incidence of pin tract deep infection. It is beneficial to select screws with short thread, or place screw thread intracutaneously. |
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